How to Use an Exercise Ball to Help with Lower Back Pain

Start with back extensions. Doing back extensions while leaning face-down on an exercise ball targets the thick paraspinal muscles of your low back while simultaneously giving a little stretch to your abdominal muscles in the front of your torso. In a way, it's like doing a "reverse sit-up." Weak and strained paraspinal muscles are a common cause of low back pain, so strengthening them on an exercise ball makes sense.^[1] Do 3 sets of 10 repetitions with 1 minute rest in between, assuming that you don't feel sharp pain when you extend your spine — if you do feel pain, then see a healthcare professional first.

• Lay with your stomach on the exercise ball with your legs outstretched, using your feet/toes for stability (wearing rubber-soled shoes is a good idea). You can also try placing your feet along the bottom of a wall.
• Then place your hands behind your head and slowly lift your upper abdominals and chest off the ball, arching your back in the process. Try to focus on contracting the muscles of your low back. Hold for a few seconds while in an extended position and then slowly lower your torso back down to the ball.
• Try squeezing your shoulder blades together to engage your upper back muscles.

Do some spinal rotations. Rotating your spine from side-to-side works out not only the paraspinal muscles right next to your spine, but also other core muscle groups such as the lateral obliques, abdominals and muscles of the pelvis. Having a strong core that works in harmony dramatically reduces the risk of back injuries and pain.^[2] If you feel sharp pain when rotating from side-to-side, then see a healthcare professional (such as a chiropractor or osteopath) first because there may be an issue in your spinal joints. Making sure your core muscle groups are relatively strong before you start rotating is a good strategy to reduce the risk of back pain. Spine rotations are another great exercise for strengthening the lower back and preventing pain, because they also simultaneously stretch the muscles of the back and core. You can repeat the exercise five times on each side, two to three times per day.

• While sitting upright on the exercise ball, raise your arms above your head (or you can place your hands on your hips), making sure that your feet are firmly on the floor for stabilization.
• Then, with your feet planted, rotate as far as you can in one direction (as if you're shoulder checking), holding for a few seconds at the end of the range. Contract the muscles in your core while you hold. Then slowly rotate back to the neutral position for a second before rotating in the opposite direction. Aim for about 10 rotations in both directions on a daily basis.
• The low back, or lumbar region, is more susceptible to injury and pain because it supports the weight of the upper body.

Add some pelvic isolations while sitting. Low back pain is sometimes caused by weak muscles in surrounding areas which forces the low back to over-compensate or overwork, resulting in injury. Your pelvic muscles are part of your core group and sometimes weakness there is responsible for low back pain.^[3] As such, strengthening your pelvic muscles is a good strategy to deal with (or help prevent) low back issues.

• With your arms by your sides or on your hips, sit on the exercise ball with your feet planted firmly on the floor. Then, gently tilt your pelvis, pulling the stomach muscles in and moving the hips forwards and upward, as if moving your hip points upward, in order to flatten the small of the back. Hold for a few seconds and then return to the starting position.
• Next, slightly arch your low back, pulling the hips backwards. Hold this position for a few seconds, then return to the starting position. This exercise can be done back and forth 10 times continuously on a daily basis.
• Alternatively, while in the same position, do slow circular rotations in one direction (clockwise) for a few minutes, then switch to the opposite direction (counterclockwise). This movement is very similar to keeping a hula hoop rotating around your hips.

Perform a bridge-like exercise. Using an exercise ball to form a "bridge" with your body is excellent for building strength in virtually all core muscle groups, including the low back, pelvis, and abdominals.^[4] Keep in mind that any exercise that utilizes the abdominal and back muscles in coordinated fashion is a good core exercise. Bridge-like exercises can be done on the floor without an exercise ball, but using one creates more instability (movement) that forces your muscles to automatically compensate for in order to maintain balance. In short, using an exercise ball makes the exercise more challenging.

• Lie down on your back with your legs straight. Lift your legs and rest your calf muscles on top of the exercise ball. Keep your arms by your side with the palms of your hands flat on the floor.
• Then, place the bottom of your feet on the ball and push your butt/pelvis off the floor. The key is to keep your torso and spine as straight as you can (which looks like a bridge). Hold the position for 10–30 seconds, then return to the relaxed position for a few seconds before repeating. Repeat the exercise five to ten times on a daily basis.
• For a more advance version, put one foot flat on the ball while straightening your other leg about six to 10 inches in the air. Keep your leg straight as you lift your butt off the ground, hold for 10–30 seconds then lower and repeat with the opposite leg.